Drug Interaction Report

Sargramostim and Lithium Carbonate: Interaction Details

A pharmacist-reviewed analysis of the Sargramostim and Lithium Carbonate interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Sargramostim

Leukine Leukine®
+

Lithium Carbonate

Lithobid
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 37 documented Sargramostim interactions, 1 is rated moderate — including this one.
Onset
delayed
Evidence
theoretical
Severity
Moderate

What happens

Increased myeloproliferative effects

Interaction Deep Dive

Avoid concomitant use of lithium, a drug that may induce myeloproliferation, and sargramostim, as the myeloproliferative effects of sargramostim may be potentiated. If concomitant use cannot be avoided, frequently monitor for clinical or laboratory signs of myeloproliferation1. Lithium has been reported to stimulate granulopoiesis and the production of colony-stimulating factor (CSF) and may enhance the action of CSF 23.

Why it happens (mechanism)

Unknown

Literature reports

1 report — tap to read

a) Lithium has been reported to stimulate granulopoiesis and the production of colony stimulating factor (CSF) in vitro 2. In a study of children with chronic neutropenia (n=17), lithium stimulated granulopoiesis in vitro. Patients with aplastic anemia and mildly reduced colony-forming unit in culture (CFU-c) values had a significant increase in CFU-c values with lithium therapy. Those with congenital or acquired neutropenia showed similar increases in CFU-c values when treated with lithium 3.

Common questions

Can I take Sargramostim and Lithium Carbonate together?

Increased myeloproliferative effects Always confirm with your pharmacist or prescriber before making any change.

How serious is the Sargramostim and Lithium Carbonate interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "delayed". Effects tend to build up gradually over days to weeks.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

From our Q&A

Real reader questions about these medications, each personally answered by our pharmacist:

Questions for your pharmacist

  • Does my dose of Sargramostim or Lithium Carbonate need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there anything you'd monitor while I'm on both?

References (3)

  1. Product Information: LEUKINE(R) subcutaneous injection, intravenous injection, sargramostim subcutaneous injection, intravenous injection. Sanofi-Aventis US LLC (per manufacturer), Bridgewater, NJ, 2018. DailyMed
  2. Galbraith PR: Effect of lithium on colony formation and production of colony-stimulating factor. Advan Exp Med Biol 1980; 127:99-109. PubMed
  3. Chan HS, Freedman MH, & Saunders EF: Stimulation of granulopoiesis in vitro and in vivo using lithium in children with chronic neutropenia. Advan Exp Med Biol 1980; 127:293-304. DOI
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Sargramostim

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Lithium Carbonate

Keep reading about Lithium Carbonate

All Lithium Carbonate interactions (317) Lithium Carbonate drug information
Also serious with: Phenelzine Tranylcypromine Zuclopenthixol Feprazone

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